Mom who is 81 and has limited medical knowledge or verbiage, took out a full policy from a company in Canada, in order to cover herself 100% for a catastrophic health event during her 7 week stay in USA. She misunderstood the word "puffer" and stated that she does not use one in her answers on questionnaire. The correct word "inhaler" was not used on form, only the word "puffer" Although the use of an inhaler, which she rarely needs anyway, and she did not even bring on her trip, is used on occasion for a cough she sometimes has. The use of an inhaler has nothing at all to do with her catastrophic event that has her in a coma and on life support in the USA. (an enteric aortic fistula) She has been penalized, and her claim for medical expenses denied for not answering correctly and saying that she uses a "puffer" They say that the policy is void even though they accepted this 81 year old widow's thousand dollars to insure herself for 7 weeks. It is not known if my mom will pull through
You should contact whatever Canadian governmental agency that regulates the business of insurance. If their system works the same way as the U.S., you should be able to file a complaint on your mother's behalf (if you've got power of attorney), or write a complaint for her to sign (if you don't have POA). The complaint will be investigated to determine whether the insurer's decision is arbitrary or capricious. |
